Mental Health Counseling

From Ryan Hansen, LPC, ATR

I am providing clinical counseling and art therapy services via telehealth to clients experiencing grief, trauma, anxiety, and depression related to the impact of social distancing/COVID-19. I also teach art therapy students at Adler University utilizing online learning and adjust learning outcomes to address the changing counseling environment related to COVID-19.

Assisting small businesses–all through the night!

From Megan Clair ’04

I started a new job with the Big 4 public accounting firm KPMG LLP in January, working in the internal audit and enterprise risk unit. As a result of the pandemic, the firm began an engagement to assist small businesses obtain funding through the CARES Act’s Paycheck Protection Program. The engagement requires overnight work. I am continually amazed at my firm’s willingness to step up and assist each other with the work. My teammates are across all our service lines (audit, tax, advisory, and business support) and the country, from Long Island to Pittsburgh to Seattle, and my Houston service line coworkers get together at midnight every Wednesday for a quick coffee break and catch-up session. While this is not at all what I expected when I jumped to public accounting, I am grateful for the learning experience.

Librarian providing remote services

From Anna Karwowski ’14

I am the youth services lead at the McHenry Public Library in McHenry, Ill. My team and I have jumped into virtual programming with both feet, developing database tutorials, storytimes, crafts and more on both Zoom and our YouTube page. We are also working hard to transition our summer reading onto Beanstack, an online platform that allows patrons to log minutes read with incentives like gift card drawings and a free book from the Friends of the Library. As the school liaison, I am in direct communication with area teachers and librarians and forwarding them information about services such as our temporary e-library card, our emergency food service during closure, and more. To see what else we are doing, follow us on Facebook or check out our YouTube page.

And, on a personal note, I have sewed about 25 masks for friends and family who need them and have more requests for masks incoming!

Costume Designers to the Rescue!

When Elizabeth Carlin-Metz, the chair of the Department of Theatre, received a request for protective face masks for a member of the Vitalist Theatre Company, she sprang into action.

The Knox experience tends to be passionately ingrained for life and results in a very closely knit network–or maybe I should say ‘stitched’ network!”

Lori Myers wears a mask
donated by
Aly Greaves Amidei.

Carlin-Metz and her late husband, Robin Metz, former director of Knox’s Creative Writing Program, founded the Vitalist Theatre in Chicago. Lori Myers, an award-winning actress and inaugural member of the company, works as a doctor of occupational therapy at Brookdale Senior Independent and Assisted Living Home Health Care and Outpatient Services in Chicago. Myers sent out a request to friends for masks.

Carlin-Metz forwarded the note to Knox theatre alumni, and Aly Greaves Amidei ’97 responded. Amidei, who majored in theatre and specialized in costume design, is now an assistant professor of costume design at the University of North Carolina, Charlotte. She has designed costumes for Vitalist and for other theaters.

“It is no surprise to me that within an hour of putting out the word that Lori needed masks in Chicago, multiple Knox Theatre costume shop alumni and current students responded from around the nation,” said Carlin-Metz. “Aly was already making masks, so she was able to respond the fastest. The Knox experience tends to be passionately ingrained for life and results in a very closely knit network–or maybe I should say ‘stitched’ network!”

Remaining resilient and adaptable

Sidharth Mahapatra ’01, pediatric critical care physician scientist

I currently live in Omaha and work at the University of Nebraska Medical Center as an assistant professor of pediatrics in the Division of Critical Care Medicine. I also have a courtesy appointment in the Department of Biochemistry where my wet lab group studies pediatric brain tumor pathophysiology.

Of note, flattening the curve does not eliminate or reduce the total numbers of affected patients. Instead, it distributes it out over time so that our medical resources can meet the demand for patient care as cases peak in different states.

Tell us about your work, your duties and responsibilities, prior to the COVID-19 pandemic.
I have dual appointments at the University of Nebraska Medical Center and the Children’s Hospital and Medical Center, Omaha, as a pediatric intensivist. As such, I staff the Pediatric Intensive Care Units (PICU) at both locations.

At UNMC, we routinely care for patients who have suffered traumas (only Level 1 trauma center for pediatrics in the state); who undergo single (kidney vs. liver) or multi-visceral organ (small bowel + liver + pancreas, only one of two programs in the country) transplants; and critically ill oncology patients (before and after bone marrow transplants or before and after brain tumor resection).

At CHMC, we run a mixed pediatric and cardiac critical care unit (60-40 split). I care for patients who have undergone heart surgeries, heart transplants, have heart failure, as well as general pediatric patients who suffer critical illnesses, such as kidney failure, septic shock, severe acute respiratory distress syndrome from pneumonia, to name a few. I chose to come to UNMC precisely for this reason, i.e., I am actively involved in ALL aspects of pediatric critical care medicine: cardiac critical care, general pediatric critical care, post-transplant care, trauma, and oncology.

Aside from my clinical responsibilities, I am the director of research for the Division of Critical Care. In this role, I mentor the young faculty who have an interest in carving a research-based career in critical care; I actively engage in clinical trials through a collaborative group of ICUs (Pediatric Acute Lung Injury and Sepsis Investigators); and I conduct my own bench research into the pathophysiology of pediatric brain tumors. To this end, I have a wet lab with two postdoctoral fellows, an appointment in the Department of Biochemistry at UNMC, and national funding through the Team Jack Brain Tumor Foundation, along with local foundation funds from UNMC.

Has the pandemic changed your role at work, and if so, how?
The pandemic has not directly changed what I do since pediatric patients have been relatively spared by the pandemic. The incidence of hospitalizations for pediatric patients is ~5 percent, with critical illness being ~1 percent. Mortalities, thankfully, have been few and far between. That said, the pandemic has given me the opportunity to leverage my research experience and national involvement to serve as the site expert in the management of COVID-induced respiratory critical illness and to avail of research opportunities in the investigation of COVID pathophysiology.

I took care of a presumed COVID positive patient in our ICU last week and had the opportunity to generate and finalize our workflow for obtaining emergency use/compassionate use approval from the FDA for the antiviral, Remdesivir. I also attend a weekly international collaborative meeting on COVID in the pediatric population, organized by Boston Children’s Hospital and attended by representatives from over 90 different PICUs worldwide; I also contribute to a national survey on COVID management practices deployed by PALISI. Taken together, I remain actively engaged in the community of pediatric critical care, keeping up-to-date on the management of COVID-related critical illness, educating my group on what I learn through my international collaborations, and expect to get involved in research investigating COVID-related pathophysiology.

More broadly, how is the pandemic affecting what you see at work on a regular basis?
Nebraska has thankfully not been hard-hit like some of our states. Within this cohort, there are only two positive pediatric patients and no pediatric deaths. Across our state, medical facilities are working collaboratively to share resources, including personal protective equipment (PPE), testing capabilities/opportunities, ventilators, etc. So, we’re in good shape to continue to tackle this pandemic should we continue our social distancing practices.

Interestingly, the pandemic has reduced our workload both in acute care and critical care settings. Telehealth has taken a stronger hold in outpatient settings and we are seeing an overall decline in all-cause admissions. This is also owed to a shift in surgical procedures to only life-threatening procedures. Census being low has thus impacted the employee work pool of active providers with non-essential staff being asked to stay home. While this brings into jeopardy overall hospital revenue, which may eventually trickle down to the providers, our leadership has assured us of stability through government relief packages. These contrarian challenges, from say, New York, are a reminder that different areas are being affected by this pandemic in unique ways.

That said, we have yet to see our peak; I’m hopeful that our preparedness will come through when the time comes. Despite these stresses, the attitude has been positive and proactive. We are all simply grateful that we have the opportunity to impact the care and survival of our most fragile patients during this difficult time.

Knox taught me one simple thing—how to adapt to a changing environment. I attended Knox after graduating from high school in Bangkok, Thailand. So, in a sense, I was socially distanced from my security blankets, i.e., my home and my family.

What is a fact and/or piece of advice you can offer to people to help them understand what is happening and how they should respond to maintain their health as well as they can?
At this critical time in our country’s history, the pandemic has yet to peak nationwide. As Dr. Fauci has recommended with social distancing practices, we have to do everything in our power to “flatten the curve.” Of note, flattening the curve does not eliminate or reduce the total numbers of affected patients. Instead, it distributes it out over time so that our medical resources can meet the demand for patient care as cases peak in different states.

The pandemic has also taught us that while pediatric patients are not at high risk, our elderly, chronically ill, and even some young and seemingly fit individuals are all at high risk. While we work feverishly to understand risk factors, pathophysiology, and mitigation factors, one thing remains certain—engaging in proper hand hygiene, social distancing, self-monitoring, and strict quarantining (with symptoms) are the most effective means to keep ourselves, our loved ones, and the most fragile parts of our society safe.

Social distancing, however, should not lead to social isolation. A better term used by some psychologists is distant socializing. It is imperative that we, as a social species, continue to remain connected, through all the available social media outlets out there. Conducting regular meet-ups with friends, families, and the like will enable our minds to appropriately adjust to these extreme isolating measures that have been taken to fight this pandemic.

Is there any way in which your Knox education has helped you adapt to the current moment?
Knox taught me one simple thing—how to adapt to a changing environment. I attended Knox after graduating from high school in Bangkok, Thailand. So, in a sense, I was socially distanced from my security blankets, i.e., my home and my family. Everything was new through this dramatic change, and everything was at first a little scary.

That said, I was not alone and most of the international students shared my sentiments, apprehensions, and fears. Thus, through that seeming adversity of social distancing, we learned to be resilient and creative. We forged life-long friendships; developed international relief efforts; participated in regular expressions of our culture; and strove for excellence in our education.

Through this transformational process, that involved as much out-of-classroom experiences, I feel I developed the skillset and mindset I needed to facilitate moving through this pandemic. Luckily, my wife (Namratra Samtani) is also a former Knox graduate from my class. And I’m sure she’d agree that our formative experiences at Knox College have played an important role in the way with which we have tackled the current situation.

What are you looking forward to once life returns to something more closely resembling “normal”?
I believe we have come upon a new “normal.” This pandemic has reminded us about the importance of staying connected and staying safe; they have also provided us with unique ways to do these while reiterating age-old recommendations. We are engaging in much more prudent hygiene and distancing practices that I hope will mitigate seasonal infections affecting our population. We have begun to understand that there are multiple ways of being productive, that working from home or away from a formal office setting can be just as if not more efficacious in our overall productivity. We have learned the true meaning of spending quality time with our loved ones and in the wisdom of not rushing through life busy in activities every moment of the waking day. So, I am looking forward to us, species-wide, applying these valuable lessons this pandemic has taught us in our new “normal.”

Is there anything else you would like to add?
I would like to thank you for this opportunity to voice my thoughts about how the current pandemic has changed us for the better and that even in the face of adversity our species remains resilient and adaptable to a new norm.

Working through a societal turning point

I would like to dedicate this to my colleague Dr. Beth Potter ’89 and her husband, Robin Carre ’85, who tragically died at the end of March 2020.  Life is clearly too short, and these two lights were lost prematurely.

From ​Mary Stoffel, ’82, OB/Gyn in a woman-owned independent private practice (proudly successful and thriving in an area where large medical systems dominate!), Madison, WI

Tell us about your work, your duties and responsibilities, prior to the COVID-19 pandemic. 
​I work doing women’s health and the full range of obstetrics and gynecology, both outpatient and in the hospital.  It is an honor and a privilege to take care of women, but also many times an added worry to have two patients in one during pregnancy. I am a senior founding partner of my medical practice, and just finished a two-year term as president of the medical staff at UnityPoint-Meriter Hospital, which is the hospital delivering the most babies (5000/year!) in Wisconsin. It’s also an honor to serve and represent my fellow clinicians in the rapidly changing world of healthcare systems.

To that end, it is imperative that the public listen to and abide by the recommendations of epidemiologists and public health officials, no matter the inconvenience.

Has the pandemic changed your role at work, and if so, how?  ​
The COVID-19 pandemic, fraught with little initial knowledge and no time to do quality research, kept everyone in healthcare moving at a very rapid pace as we have all tried to learn, do, care, and protect. It is especially nerve-wracking in obstetrics, as even the best research in medicine is rarely done well in pregnant women, and the degree of anxiety is high, the effects often delayed in discovery. In addition, as a medical practice and small business owner, there were lots of sudden pivots to make to provide safety to our patients, our staff and ourselves. We had to quickly begin a telehealth program and also revamp everything in the hospital environment. 

More broadly, how is the pandemic affecting what you see at work on a regular basis, e.g., employee workloads, the number of patients seeking help? 
​Oddly, our patients (and most patients) have seemed to take the cue that routine things can wait, which gave us the time and energy to deal with care that can’t wait! Our patients were also appreciative of our workflow design to keep them safe and still provide compassionate care. Our employees and staff were courageous, grateful, and calm despite their nervousness and some early COVID-19 exposures. Our employees, recognizing the financial impact of all of our practice changes, voluntarily worked out an appropriate coverage schedule that also was sensitive to the fact that our intention was to continue to pay all of them without furloughs or lay-offs. I am proud of how we have treated them. As much of a crisis as this has been, it has been extremely heart-warming to see the amount of cooperation, mutual care, and sense of community that we always knew was around us.

What is a fact and/or piece of advice you can offer to people to help them understand what is happening and how they should respond to maintain their health as well as they can?  
This “clever virus”–as one of my virologist acquaintances called it–can be devastating to those who suffer the worst consequences. The medical and scientific world is still learning to identify why some COVID-19 victims are completely asymptomatic carriers and why some traverse the entire course to severe respiratory distress and even death. Age, underlying conditions, and viral exposure load seem to be clear risk factors, but so much is not understood. To that end, it is imperative that the public listen to and abide by the recommendations of epidemiologists and public health officials, no matter the inconvenience.

By the same token, diligence, common sense and listening to reliable sources (as this information changes daily) will help keep most people safe and well, and it is important to extend this to protecting those who are at highest risk.

Is there any way in which your Knox education has helped you adapt to the current moment? 
I am grateful for my Knox education giving me the ability to think critically (in evaluating the reliability of various sources of information), the ability to think creatively (in helping to come up with solutions to problems never faced before), the humanity to compare the ethics of various courses of action when none seemed optimal, and the resilience and tenacity to work quickly and thoroughly (I’m lookin’ at you, Freshman Preceptorial!). I firmly believe that a liberal arts education provides these skills much more completely than a more proscribed STEM education, as valuable as that is.

What are you looking forward to once life returns to something more closely resembling “normal”? 
I am looking forward to being able to safely see my father (Don Stoffel, ’54), who has been isolated in his senior apartment complex for several weeks. I am looking forward to seeing my grown children more (including Eva Marley, ’13). Having just down-sized and moved to a downtown apartment, I will selfishly love having access to all the arts venues, restaurants, farmers markets, and other life joys that are currently closed down. Most importantly, I will enjoy not having to worry if every weird clinical situation could be an atypical presentation of COVID-19. And I will enjoy delivering a baby without full hot and uncomfortable PPE. It’s the little things …

This pandemic will be a turning point for society, and many things will likely never be the same. “What were you doing during the pandemic?” will be a common story for grandchildren to come, and how this is managed will affect us for many generations. I hope science and reason will take hold over societal and political motivators.

More tips for schooling at home

From Joel Estes, Visiting Instructor and Chair, Educational Studies

Families have varying abilities to address their children’s educational needs during the pandemic. Some are limited by internet access, some have limited time to work with kids at home, some have vastly changed home circumstances (additional people in the home, at home job responsibilities, unemployment, etc.) Many families with children in K-12 schools are facing difficult and dire circumstances. With that being said, I would give the following recommendations:

  • Connect with your child’s school and district. Try to follow their guidelines and use their resources. Most school districts in Illinois have adopted elearning systems and some have even provided tablets and internet access. Some are providing food for kids during the shutdown. Use those resources!
  • Parents should make sure to continue to do what they’ve always done as their children’s first teachers: read with them, play games, allow them to help with family chores like cooking, yardwork, and cleaning. This will not only keep kids’ brains stimulated, it will make them feel like they’re a part of the team. They need to know that we’re all in this together.
  • Finally, I would advocate that parents limit their children’s screen time. With elearning there will already be a healthy dose of that, and there’s lots of research out there that proves the negative effects of too much time watching TV, using the computer, or being on cell phones. Parents should also be aware of the media that they have playing in the home. Just having the television turned on to nonstop news coverage and running in the background may have negative effects on your child’s psyche. 

In addition to academics, parents should focus on the social and emotional needs of their children. This pandemic is tough on everyone, but children are the most vulnerable and can easily absorb tension and worry from their parents. Above all, parents should model patience, adaptability, and positivity. They should make sure that they are reassuring and positive with their children. Make sure that your kids know everything is going to be okay. 

Schooling at home tips

From Eric Dickens, assistant professor of educational studies

Tips for parents teaching kids at home during COVID-19:

  • Deciding what your child could and should be learning is a big challenge. Some schools and teachers may be sending work home that keeps students moving through their plan for the year, but some parents may not be getting this kind of material and guidance. If not, try reaching out to your child’s teachers to learn as much as you can about what learning standards and assignments the students had been working on and were going to be learning about for the rest of the school year. Most students will enter new grade levels next year, and your child’s teachers will expect/assume a certain amount of background knowledge from what they learned this year. It’s a good idea to make sure your child is making progress toward being ready for next year, and not just doing “busy work.”
  • Homeschooling parents and teachers might be tempted to try to replicate the classroom assignments at home, but obviously the classroom and home setting are very different! Try to “rethink” your child’s learning at home–learning not as copying what students do in the classroom, but as engaging “home work.” Research on home work best practices says it is most effective when it takes advantage of learning a child can do only at home, instead of being “classwork done at home.”  Instead of having your child working on “paper and pencil” assignments like worksheets, reading textbook chapters, and watching instructional videos, try to create ways to play with the same ideas using things found only at home–family members, outside spaces, objects from around the house. There are YouTube videos and homeschooling websites to help generate ideas for at home learning that is play- and project-based and takes advantage of people, spaces, and objects kids have at home.
  • Developmentally speaking, children and adolescents really benefit from having a structure to their day. At school, children usually have set schedules, but at home those time blocks may be gone and replaced by large chunks of time. Create a daily schedule and routines for your child, maybe ones that copy their daily school schedule. Do your kids start the day with a morning meeting? When do they have recess? How long are their class periods or blocks? Giving your child a structure with “progress checks” and deadlines throughout the day will help them self-regulate their own learning.

Natural and integrated global community

Knox reached out to some of our graduates who are working in the healthcare industry for their perspectives on the COVID-19 pandemic.

From Stephanie Hasan Detterline ’98
I am an internal medicine program director for a regional healthcare system in the Mid-Atlantic, MedStar Health. I oversee the largest community-based residency program in the US–150 trainees with a future in internal medicine here in Baltimore, Maryland.

My work is in four Baltimore hospitals, all under the MedStar umbrella. We live in Phoenix, MD, in Baltimore County.

Instead of creating a fear of “other,” Knox provided an atmosphere that supported everyone’s right to be different and allowed our differences to be interesting and intriguing and not scary and threatening. It is now more important than ever to see our global community as natural and integrated.

Tell us about your work, your duties and responsibilities, prior to the COVID-19 pandemic.
Before the pandemic, I spent most of my time in administrative work, overseeing the educational curriculum of the residents and making sure our teaching faculty are high quality and satisfied. I met with residents regularly and filled my days with meetings, scheduling, planning events such as orientation and recruiting our next class of trainees.

Has the pandemic changed your role at work, and if so, how?
The pandemic has changed everything. Now our meetings are online, and we spend our time thinking about personal protective equipment (PPE), moral distress, and protecting our trainees from excessive strain and exposure. We are meeting over video instead of in person, making alternate plans for orientation, graduation and recruitment next year, and trying to figure out how to hug people from afar.

More broadly, how is the pandemic affecting what you see at work on a regular basis, e.g., employee workloads, the number of patients seeking help?
In Maryland, the pandemic so far has been more anti-climactic than anything … and that is a blessing! We spend a lot of time in preparation and we are now waiting to see where things go. There are more worried, well, anxious patients who need reassurance and to know they will not be abandoned in their time of greatest need.

What is a fact and/or piece of advice you can offer to people to help them understand what is happening and how they should respond to maintain their health as well as they can?
I would say people should attend to their health, make sure they are exercising daily and maintaining a healthy weight. Any chronic conditions should be well-controlled. They should seek out evidence-based sources of medical information and always seek out the truth.

Is there any way in which your Knox education has helped you adapt to the current moment?
My Knox education has been tremendously important during all of my career and, particularly, at this moment. Knox was the first place I was exposed to people of many cultures and different belief systems. Instead of creating a fear of “other,” Knox provided an atmosphere that supported everyone’s right to be different and allowed our differences to be interesting and intriguing and not scary and threatening. It is now more important than ever to see our global community as natural and integrated. We don’t have time to be afraid of people who are different as we must band together to fight a global pandemic.

What are you looking forward to once life returns to something more closely resembling “normal”?
I am so looking forward to my kids going back to school so I don’t have to be their teacher anymore! I have gained a new appreciation for our educators during this crisis.

I have been so impressed and inspired by the love and goodness of our providers during this time. It can restore anyone’s faith in humanity.

Take the virus seriously

Knox reached out to some of our graduates who are working in the healthcare industry for their perspectives on the COVID-19 pandemic.

From Dr. Adam Nader ’07
I currently live in Miami, Florida, and am employed in a private practice cardiology group. I currently see patients in the office and in the hospital.

Tell us about your work, your duties and responsibilities, prior to the COVID-19 pandemic.
I have been involved in the care of COVID-19 patients in both settings. Prior to the pandemic, I would perform outpatient clinical cardiovascular services which include clinical risk assessment, echocardiogram (both non-invasive and invasive echocardiogram studies), stress test, electrocardiogram interpretation as well as inpatient care of patients with cardiovascular disease and illnesses.

Please help the vulnerable, those in the healthcare field, and society at large by staying home.

Has the pandemic changed your role at work, and if so, how?
The pandemic has changed the landscape of my profession. In addition to taking care of COVID-19 patients, the pandemic has caused us to change the method of which we interact with our patients. This has led to the usage of telemedicine widespread for the first time (previously only used for rural medical practice). I find myself engaging in this method frequently now instead of personal face to face interaction with my patients. Also in the hospital, the constant use of personal protective equipment (PPE) and disinfecting medical equipment has become even greater of a necessity than it was before.

The pandemic has also led me and others in my profession and field to be concerned and disappointed at the availability of PPE. This is more of a concern for certain members of the healthcare field than others, of course, but it is distressing to feel that my colleagues are being placed on the lines without adequate means to protect themselves from a highly contagious virus. The Washington Post reported to date 9,000 members of the healthcare profession have been infected from COVID-19.

What is a fact and/or piece of advice you can offer to people to help them understand what is happening and how they should respond to maintain their health as well as they can?
My biggest piece of advice for people is to take this virus seriously. It can affect the young and old and you can even spread it without realizing it to a vulnerable person. Handwashing, avoiding touching your face, social distancing, and wearing facial covering is extremely important during these times. Please help the vulnerable, those in the healthcare field, and society at large by staying home.

I am truly looking forward to the day when I do not have to worry about bringing the virus home to my family.